Adult dyslipidemia prediction is improved by repeated measurements in childhood and young adulthood. The Cardiovascular Risk in Young Finns Study. Issue 2 (April 2015)

• Record Type: Journal Article
• Authors: Nuotio, Joel; Oikonen, Mervi; Magnussen, Costan G.; Viikari, Jorma S.A.; Hutri-Kähönen, Nina; Jula, Antti; Thomson, Russell; Sabin, Matthew A.; Daniels, Stephen R.; Raitakari, Olli T.; Juonala, Markus
• Is Part Of: Atherosclerosis. Volume 239:Issue 2(2015)
• Page Start: 350
• Page End: 357
• Publication Date: 2015-04
• Subjects: Lipids -- Atherosclerosis -- Follow-up studies -- Risk factors; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2015.02.004
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background: Prediction of adult dyslipidemia has been suggested to improve with multiple measurements in childhood or young adulthood, but there is paucity of specific data from longitudinal studies. Methods and results: The sample comprised 1912 subjects (54% women) from the Cardiovascular Risk in Young Finns Study who had fasting lipid and lipoprotein measurements collected at three time-points in childhood/young adulthood and had at least one follow-up in later adulthood. Childhood/young adult dyslipidemia was defined as total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C) or triglycerides (TG) in the highest quintile, or high-density lipoprotein cholesterol (HDL-C) in the lowest quintile. Adult dyslipidemia was defined according to European cut-points (TC > 5.0 mmol/L, LDL-C >3 mmol/L, Non-HDL-C >3.8 mmol/L, HDL-C <1.0 mmol/L (in men)/<1.2 mmol/L (in women) and TG > 1.7 mmol/L). With the exception of triglycerides, Pearson correlation coefficients for predicting adult levels significantly improved when two lipid or lipoprotein measurements in childhood/young adulthood were compared with one measurement (all P < 0.01). For triglycerides, there was significant improvement only when three measurements were considered (P = 0.004). Two measurements significantly improved prediction of dyslipidemia levels in adulthood for non-HDL-C, LDL-C, HDL-C and TG compared with one measurement (P < 0.05 for improved area-under the receiver-operating characteristic curve). Risk of dyslipidemia in adulthood grew according to the number of times a person had been at risk in childhood. Conclusions: Based on these results, it seems that compared to a single measurement two lipid measures in childhood/early adulthood significantly improve prediction of adult dyslipidemia. A lack of dyslipidemia in childhood does not strongly exclude later development of dyslipidemia. Multiple measurements increase the prediction accuracy, but the incremental prognostic/diagnostic accuracy of especially third measurement is modest. Highlights: Lipid levels are major modifiable risk factors for atherosclerosis. Lipid levels have a tendency to track from childhood to adulthood. Prediction of adult dyslipidemias is more accurate with two childhood measurements.